Tesis

Tren Tatalaksana Kanker Prostat Lokal Lanjut Di Indonesia = Trends of Locally Advanced Prostate Cancer Managements in Indonesia.

Tujuan: Mengevaluasi tren tatalaksana kanker prostat stage T3 berdasarkan faktor-faktor yang mempengaruhi.
Material dan Metode: Studi retrospektif tatalaksana kanker prostat stage T3 di Rumah Sakit Cipto Mangunkusumo dan Rumah Sakit Kanker Dharmais periode 1995-2013. Data tren pemilihan terapi antara radioterapi atau terapi hormonal dianalisis berdasarkan kelompok tahun terapi, kadar PSA, grade tumor dan kelompok usia.
Hasil: Dari 50 subjek, 25 (50%), 23 (46%) and 2(4%) subjek mendapatkan tatalaksana radioterapi, terapi hormonal dan prostatektomi radikal, secara berturutan. Perubahan tren pemilihan terapi berdasarkan tahun terapi secara statistik signifikan (p=0.012), dengan mengeksklusikan kelompok periode terapi 1995-1999. Terapi hormonal lebih menjadi pilihan untuk kelompok tumor high grade(53.8%) dan lebih sering dipilih seiring bertambahnya usia pasien. Kadar PSA tidak mempengaruhi tren pemilihan terapi.
Kesimpulan: Terdapat perubahan yang bermakna dalam pemilihan terapi kanker prostat stage T3 berdasarkan tahun terapi. Terapi hormonal lebih menjadi pilihan pada kasus dengan tumor high grade dan kelompok usia yang semakin tua.
Kata Kunci: kanker prostat lokal lanjut, radioterapi, terapi hormonal, tren terapi


Objective: To evaluate treatment trend of stage T3 prostate cancer based on several factors. Materials and Methods: A retrospective study was done on stage T3 prostate cancer patients from year 1995-2013, at two national referral hospitals in Indonesia. Treatment trends between hormonal therapy and radiotherapy based on year of treatment, PSA level, tumor grade and age groups were evaluated. Results: On 50 patients subjects, 25 (50%), 23 (46%) and 2(4%) subjects were treated by radiotherapy, hormonal therapy and radical prostatectomy, respectively. Year of treatment were significantly associated with treatment selection (p=0.012), after excluding year of treatment 1995-1999 group. Hormonal therapy was preferred on high grade tumor group (53.8%) and more applied for older patients. Treatment trend was not affected by PSA level. Conclusion: Year of treatment were significantly associated with treatment selection of stage T3 prostate cancer. Hormonal therapy was preferred on high grade tumor group and older age groups.
Key words: hormonal therapy, locally advanced prostate cancer, radiotherapy, treatment trend